Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Neurol Sci. 2022 Mar;43(3):1709-1719. doi: 10.1007/s10072-021-05544-0. Epub 2021 Aug 19.
The Frontal Assessment Battery (FAB) is a neuropsychological tool largely used to assess executive functions. Prior studies found a marked ceiling effect for the prehension behavior subtest (PBT) in healthy and clinical populations. Aims of the present study were (i) to examine the psychometric properties of the FAB without the contribution of PBT and (ii) to provide normative data for a revised version of the FAB after exclusion of PBT (FAB15).
The normative sample included 1,187 healthy participants. PBT had near-zero variance, poor content validity, and no discrimination power. Internal consistency increased when PBT was excluded. We assessed the FAB15 factorial structure, interrater, and test-retest reliabilities. Normative data for the FAB15 were extracted through a regression-based procedure according to sex, age, and education.
The principal component analysis revealed a single "executive factor" or alternatively a bifactorial solution reflecting the different degree of discriminative capability vs. difficulty of the subtests. The FAB15 demonstrated excellent interrater and test-retest reliabilities. Regression analysis showed that sex (lowly educated women < lowly educated men), higher age, and lower education affected FAB15 score. Accordingly, three grids for adjustment of raw scores (men, women, and both) were constructed. The cut-off was fixed at the non-parametric outer tolerance limit on the fifth centile (9.36, 95% CI).
The observation of a ceiling effect in healthy subjects makes PBT not suitable for inclusion in a neuropsychological battery. The FAB15 may successfully replace the conventional FAB as a more severe and valid short screening tool to assess executive functioning.
额叶评估测验（FAB）是一种主要用于评估执行功能的神经心理学工具。先前的研究在健康人群和临床人群中发现，抓握行为测验（PBT）存在明显的天花板效应。本研究的目的是（i）在不包括 PBT 的情况下检查 FAB 的心理测量特性，以及（ii）在排除 PBT 后（FAB15）为 FAB 的修订版本提供正常值。
本研究的正常值样本包括 1187 名健康参与者。PBT 的方差几乎为零，内容效度较差，没有判别力。排除 PBT 后，内部一致性增加。我们评估了 FAB15 的因子结构、评分者间信度和重测信度。根据性别、年龄和教育程度，通过回归分析提取 FAB15 的正常值数据。
主成分分析显示出单一的“执行因子”，或者反映出不同难度和区分能力的二分法解决方案。FAB15 显示出优秀的评分者间信度和重测信度。回归分析显示，性别（低教育程度的女性<低教育程度的男性）、较高的年龄和较低的教育程度会影响 FAB15 分数。因此，构建了三个调整原始分数的网格（男性、女性和两者）。截断值固定在第五百分位的非参数外限（9.36，95%置信区间）。
在健康受试者中观察到的天花板效应使得 PBT 不适合包含在神经心理学测试中。FAB15 可以成功地替代传统的 FAB，成为一种更严格和有效的评估执行功能的短筛查工具。
